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©The Author(s) 2021.
World J Gastroenterol. May 21, 2021; 27(19): 2353-2365
Published online May 21, 2021. doi: 10.3748/wjg.v27.i19.2353
Published online May 21, 2021. doi: 10.3748/wjg.v27.i19.2353
Table 1 Demographic and clinical characteristics of patients with Crohn’s disease according to the presence of acute severe lower gastrointestinal bleeding
Bleeding group (n = 75) | Non-bleeding group (n = 1359) | P value | |
Age at diagnosis, years (median, IQR) | 23.6 (18.9-31.9) | 23.2 (18.6-33.5) | 0.952 |
Sex, male, n (%) | 63 (84.0) | 1000 (73.6) | 0.045 |
Disease location at diagnosis, n (%) | 0.002 | ||
Ileum | 34 (45.3) | 377 (27.7) | |
Colon | 1 (1.3) | 81 (6.0) | |
Ileocolon | 40 (53.4) | 901 (66.3) | |
Upper GI modifier at diagnosis, n (%) | 15 (20) | 355 (26.1) | 0.238 |
Disease behavior at diagnosis, n (%) | 0.157 | ||
Non-stricturing, non-penetrating | 59 (78.6) | 1012 (74.5) | |
Stricturing | 11 (14.7) | 155 (11.4) | |
Penetrating | 5 (6.7) | 192 (14.1) | |
Perianal modifier at diagnosis, n (%) | 32 (42.7) | 686 (50.5) | 0.204 |
Smoking status at diagnosis, n (%) | 0.540 | ||
Never smokers | 51 (68.0) | 874 (64.3) | |
Ex-smokers | 3 (4.0) | 99 (7.3) | |
Current smokers | 21 (28.0) | 386 (28.4) | |
Early use of medications, n (%) | |||
Corticosteroids | 21 (28.0) | 399 (29.4) | 0.840 |
Thiopurines | 10 (13.3) | 649 (47.8) | < 0.001 |
Anti-TNF agents | 1 (1.3) | 43 (3.2) | 0.560 |
Table 2 Risk factors of acute severe lower gastrointestinal bleeding in patients with Crohn’s disease
Univariate analysis | Multivariable analysis | |||
HR (95%CI) | P value | HR (95%CI) | P value | |
Age at diagnosis | 1.01 (0.98-1.03) | 0.663 | ||
Sex | ||||
Male | Reference | Reference | ||
Female | 0.51 (0.28-0.95) | 0.035 | 0.51 (0.27-0.94) | 0.031 |
Disease location at diagnosis | ||||
Colon | Reference | Reference | ||
Ileum | 7.56 (1.04-55.26) | 0.046 | 6.58 (0.90-48.12) | 0.063 |
Ileocolon | 3.60 (0.50-26.22) | 0.206 | 3.86 (0.53-28.09) | 0.182 |
Upper GI modifier at diagnosis | ||||
No | Reference | |||
Yes | 0.78 (0.45-1.38) | 0.401 | ||
Disease behavior at diagnosis | ||||
Non-stricturing, non-penetrating | Reference | |||
Stricturing | 1.10 (0.58-2.10) | 0.763 | ||
Penetrating | 0.45 (0.18-1.13) | 0.067 | ||
Perianal modifier at diagnosis | ||||
No | Reference | Reference | ||
Yes | 0.71 (0.45-1.12) | 0.142 | 0.74 (0.42-1.19) | 0.209 |
Smoking status at diagnosis | ||||
Never smokers | Reference | |||
Ex-smokers | 0.59 (0.18-1.88) | 0.368 | ||
Current smokers | 0.93 (0.56-1.55) | 0.783 | ||
Early use of medications | ||||
Corticosteroids | 0.94 (0.57-1.58) | 0.840 | ||
Thiopurines | 0.17 (0.09-0.34) | 0.001 | 0.23 (0.12-0.48) | < 0.001 |
Anti-TNF agents | 0.41 (0.12-3.21) | 0.560 |
Table 3 Comparison of the baseline parameters between patients with acute severe lower gastrointestinal bleeding and matched patients without
Before matching | After matching | |||||
Bleeding group (n = 75) | Non-bleeding group (n = 1359) | SMD | Bleeding group (n = 72) | Non-bleeding group (n = 267) | SMD | |
Age at diagnosis, years (median, IQR) | 23 (18-32) | 23 (18-33) | 0.009 | 22 (18-31.5) | 23 (18-30) | 0.061 |
Male, n (%) | 63 (84.0) | 1000 (73.6) | 0.257 | 63 (87.5) | 234 (87.6) | 0.004 |
Disease location at diagnosis, n (%) | 0.391 | 0.020 | ||||
Ileum | 34 (45.3) | 377 (27.7) | 31 (43.1) | 111 (41.6) | ||
Colon | 1 (1.3) | 81 (6.0) | 1 (1.4) | 4 (1.5) | ||
Ileocolon | 40 (53.3) | 901 (66.3) | 40 (55.6) | 152 (56.9) | ||
Disease behavior at diagnosis, n (%) | 0.301 | 0.030 | ||||
Non-stricturing, non-penetrating | 59 (78.7) | 1012 (74.5) | 58 (80.6) | 219 (82.0) | ||
Stricturing | 11 (14.7) | 155 (11.4) | 9 (12.5) | 32 (12.0) | ||
Penetrating | 5 (6.7) | 192 (14.1) | 5 (6.9) | 16 (6.0) |
Table 4 Comparison of the outcome parameters between patients with acute severe lower gastrointestinal bleeding and matched patients without during the period before the bleeding/index date
Bleeding group (n = 72) | Non-bleeding group (n = 267) | Matched OR (95%CI) | P value | |
Use of medications, n (%) | ||||
Corticosteroids | 19/72 (26.4) | 78/267 (29.2) | 0.82 (0.43-1.57) | 0.55 |
Thiopurines | 27/72 (37.5) | 108/267 (40.4) | 0.74 (0.36-1.51) | 0.40 |
Anti-TNF agents | 6/72 (8.3) | 27/267 (10.1) | 0.68 (0.24-1.91) | 0.47 |
Behavioral progression, n (%) | 10/58 (17.2) | 21/219 (9.6) | 1.96 (0.87-4.44) | 0.10 |
Intestinal resection, n (%) | 13/72 (18.1) | 30/267 (11.2) | 1.83 (0.73-4.58) | 0.20 |
Table 5 Comparison of the hospitalization rate between patients with acute severe lower gastrointestinal bleeding and matched patients without
Hospitalization rate (per 100 patient-years) | Bleeding group (n = 72) | Non-bleeding group (n = 267) | Hospitalization rate ratio (95%CI) | P value |
Before bleeding/index date (95%CI) | 21.0 (14.5-30.5) | 23.6 (19.0-29.2) | 0.89 (0.58-1.37) | 0.599 |
After bleeding/index date (95%CI) | ||||
Excluded: Index hospitalization | 22.1 (16.5-29.4) | 13.2 (11.2-15.5) | 1.67 (1.20-2.33) | 0.012 |
Excluded: Hospitalizations due to bleeding | 14.5 (10.3-20.4) | 13.2 (11.2-15.5) | 1.10 (0.75-1.60) | 0.631 |
- Citation: Yoon J, Kim DS, Kim YJ, Lee JW, Hong SW, Hwang HW, Hwang SW, Park SH, Yang DH, Ye BD, Byeon JS, Myung SJ, Yang SK. Risk factors and prognostic value of acute severe lower gastrointestinal bleeding in Crohn’s disease . World J Gastroenterol 2021; 27(19): 2353-2365
- URL: https://www.wjgnet.com/1007-9327/full/v27/i19/2353.htm
- DOI: https://dx.doi.org/10.3748/wjg.v27.i19.2353